Purging episodes score=primary purging behaviour (episodes of vomiting, or laxative, diuretic or enema/suppository misuse).
If, by that time, there is no improvement in constipation, then colonoscopy or barium enema and sigmoidoscopy should be done.
If society is willing to pay $60,000 for a year of life, 5-year double-contrast barium enema is the best candidate.
Constipation may be managed by ensuring adequate fluid and fibre, followed if necessary by stool softeners, laxatives, suppositories and enemata.
Purging episodes score=primary purging behaviour (episodes of vomiting, or laxative, or diuretic or enema/suppository misuse).
Severely demented faecally incontinent people had a regimen of planned bowel emptying using enemas and codeine phosphate.
The best combination, in our experience, is of a systemic laxative and a locally acting one, such as enema or suppositories.
Flexible sigmoidoscopy and barium enema were found to be more cost-effective than some of the other screening tools by other researchers (5;15;34).
